# DR. KYLE FISTNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1407377013
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0116030955 | VA | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 25MB12608300 | NJ | Yes |

## Other

- **Enumeration date:** 07/05/2017
- **Last updated:** 02/02/2026